SOCIAL DETERMINANTS OF HEALTH AND AGING: DISPARITIES AND BARRIERS TO ORAL HEALTH CARE AMONG OLDER ADULTS IN ALABAMA

Abstract Limited data exists on the oral health status of the older adult population of Alabama; improved surveillance programs are needed for estimations and planning. Aim: This study compares gender, racial, and economic differences in barriers to oral healthcare among older adults in Alabama. Methods: Self-reported, voluntary surveys including sociodemographics, oral care behaviors, and care utilization were completed along with intraoral screenings at senior centers and senior living communities. Univariate analyses were conducted using Chi-Square or Fisher’s Exact test, p< 0.05 considered meaningful. Results: 357 respondents were assessed: mean age 73.4 (SD 8.4), 70.3% female, 57.1% Black/African American (AA), 42.9% Caucasian (Ca), 88.8% sole source of income Social Security/Disability. Ca were more likely than AA to have dental insurance (65.0 vs 51.5%, p=0.013), and more likely to have had a cleaning/check-up (20.9 vs 12.3%, p=0.029). Those with income <$1500/month who received dental care were more likely to receive care for dentures compared to those with higher income (17.1 vs 8.0%, p=0.030). Those still driving who received dental care were more likely to have had a cleaning/check-up compared to those not still driving (20.9 vs 9.2%, p=0.025). Untreated tooth decay was detected in 25% of those with remaining dentition and was more common among AA than Ca (57.4 vs 44.4%, p=0.035). Conclusions: The preliminary analysis points to the need to further explore access to oral health services for older Alabamians living independently. Further data is needed for planning and policy making. Barriers to care were not explored for those who are homebound.

United States, 2. University of Illinois at Chicago,Chicago,Illinois,United States,3. University of Pittsburgh,Pittsburgh,Pennsylvania,United States African American and Black persons experience significant disability after stroke.They also experience high external stressors, including discrimination, which may attenuate stroke recovery.Further understanding of the associations among external stressors, disability severity, and attenuated recovery are important to reduce healthcare disparities and improve patient outcomes.However, persons of the same race may not have the same lived experiences due to variations in social characteristics such as age or education.Associations between these social characteristics and perceived discrimination may offer insights into the recovery of older adult African American and Black stroke survivors.We conducted a secondary analysis of 11 poststroke patients who were recruited to participate in the Black Lived Experiences of Stroke Study (female=10, age=67±11, ≥2 years post-secondary education=63%) to assess the frequency of perceived discrimination.Perceived discrimination was measured with the Everyday Discrimination Scale survey.We examined correlations between age and education and perceived discrimination using Cramer's V tests.Semi-structured participant interviews were also examined for examples of perceived discrimination during poststroke healthcare.Nine participants reported perceived discrimination post-stroke.Analyses revealed a clinically meaningful but not statistically significant relationship between chronological age and perceived discrimination (Cramer's V=0.62, p=0.12).There was no meaningful relationship between educational level and perceived discrimination.All participants reported challenges with communication, missed diagnoses and poor delivery of care poststroke.Findings support the need for additional research to examine the relationships between participants' social characteristics and perceived discrimination among Black and African American stroke survivors, and the impact on stroke recovery.
African American (AA), 42.9% Caucasian (Ca), 88.8% sole source of income Social Security/Disability. Ca were more likely than AA to have dental insurance (65.0 vs 51.5%, p=0.013), and more likely to have had a cleaning/check-up (20.9 vs 12.3%, p=0.029).Those with income <$1500/month who received dental care were more likely to receive care for dentures compared to those with higher income (17.1 vs 8.0%, p=0.030).Those still driving who received dental care were more likely to have had a cleaning/check-up compared to those not still driving (20.9 vs 9.2%, p=0.025).Untreated tooth decay was detected in 25% of those with remaining dentition and was more common among AA than Ca (57.4 vs 44.4%, p=0.035).Conclusions: The preliminary analysis points to the need to further explore access to oral health services for older Alabamians living independently.Further data is needed for planning and policy making.Barriers to care were not explored for those who are homebound.Background: There have been several international reviews about aging LGBTQI health and living conditions, but where policy, social insurance, and services differ.The Public Health Agency of Sweden was given a government assignment to review the literature on LGBTI, emphasizing Scandinavian literature.Method: This scoping review includes peerreviewed literature published in English or Scandinavian languages from January 1, 2012, to May 2022.Literature was searched in PsycINFO, PubMed, Web of Science, CINAHL, International Bibliography of the Social Sciences (IBSS), Social Science Database, Applied Social Sciences Index & Abstracts (ASSIA), and Sociological Abstracts, Sociology Database.Initially, 11,428 articles were found.After removing duplicates using Rayyan and reviewing titles and abstracts, 54 articles were read in full.After the final review, 16 articles remained.Thematic analysis was used to produce themes from the reviewed literature.Findings: The following two themes were identified: Aspects of health and Living conditions.Studies were primarily interpretive.There is a lack of studies about some subgroups of older LGBTQ people in this context; for instance, there are insufficient studies on older lesbian women and gay men.Furthermore, there is a lack of studies on somatic health for older LGBTQ people, generally.Comparatively, albeit in small samples, we better understand trans descriptions of aging than lesbian women and gay men.There were no studies found on intersex individuals.Implications: There remains a paucity of literature regarding the life and living conditions for LGBTQI older adults in Nordic countries.

THE INFLUENCE OF RURALITY AND FRAILTY ON HEALTH OUTCOMES IN OLDER ADULTS
Hillary Spangler 1 , Emma Mitchell 2 , David Lynch 1 , Perry Haaland 2 , and John Batsis 1 , 1. UNC School of Medicine, Chapel Hill, North Carolina, United States, 2. UNC Chapel Hill, Chapel Hill, North Carolina, United Sta tes Background: Frailty is a syndrome representing a decline in physical function and an increased vulnerability to stressors.Older adults in rural areas may be at increased risk for frailty and adverse outcomes due to worse overall health.Our aim was to identify how rural/urban residence can influence frailty status.Methods: We used National Health andAging Trend Study (2011-2020) data, a cohort of Medicare beneficiaries.Participants were categorized as robust, pre-frail, and frail (Fried's frailty phenotype).Rural residence included counties outside of a metropolitan statistical area (Office of Management and Budget).Participants were excluded if frailty components or geographical status were incomplete.We used logistic regression analyses for the relationship between adverse outcomes (death, nursing home placement over 2011-2020), rural/urban, and frailty status.Results: Of 7,393 participants (57.2% female), median age range was 75-80 years and 19.4% were rural residents.Rates of robust, pre-frailty, and frailty were 41.4%, 48.4%, and 10.2%, respectively.There was no difference of frailty status by rural status nor was there a frailty x rural interaction.Older adults with pre-frailty (OR=1.18;1.05-1.34)and frailty (OR=1.01;0.82-1.24)had higher risk of residing in rural than urban areas.Rural residence (OR=1.75;1.33-2.24),pre-frailty (OR=1.87;1.54-2.28)and frailty (OR=3.62;2.79-4.71)had higher risk of adverse outcomes.Conclusion: Participants with pre-frailty had higher odds of living in a rural area.Similarly, participants in rural areas had higher odds of adverse outcomes.These findings may highlight health care disparities in rural areas and opportunities for system-and individual-level interventions to prevent frailty development.

BIOLOGY OF AGING
Abstract citation ID: igad104.2477

A BAYESIAN NETWORK-BASED APPROACH FOR MULTI-OMICS INTEGRATION TO REVEAL UNDERLYING MECHANISMS OF HEALTHY AGING
Anastasia Leshchyk 1 , Stefano Monti 1 , and Paola Sebastiani 2 , 1. Boston University, Boston, Massachusetts, United States, 2. Tufts Medical Center, Boston, Massachusetts, United Sta tes Previous research on long-lived individuals showed that centenarians significantly delay the onset of the disability and aging-related diseases such as Alzheimer's, dementia, and cardiovascular diseases to the very end of their lives compared to the general population.Genetic studies of centenarians and healthy agers showed that carriers of the APOE e2 allele had increased odds of reaching longevity compared to the non-e2 allele carriers.In addition, the APOE e2 allele is characterized by distinct serum proteomics and metabolomics profiles that could be useful to understand the mechanism of propagation of the genetic effect of APOE to the molecular level and eventually to phenotypes.We are developing a novel network-based approach of multi-layer data integration to identify shared molecular